Cervical collar having height and circumferential adjustment

ABSTRACT

A cervical collar has a front component formed from a compressible foam material and defines a recess constituting part of a tracheal opening. The collar also has a height adjustment mechanism secured to the front component which forms a substantially rigid border about the tracheal opening, and a sternum pad formed from a compressible foam material. The height adjustment mechanism selectively connects the front component to the sternum pad at a permanently locked position among a plurality of predefined distances.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. provisional patentapplication 61/232,559, filed on Aug. 10, 2009, and U.S. provisionalpatent application 61/328,830, filed on Apr. 28, 2010. This applicationincorporates in its entirety the disclosure of U.S. provisionalapplications 61/232,559 and 61/328,830.

FIELD OF THE INVENTION

The invention generally relates to the field of orthopedic or prostheticdevices and more specifically to a cervical collar arranged toaccommodate a variety of wearer sizes including height andcircumferential width adjustment, improve patient comfort and adjust orset the collar for different medical indications.

BACKGROUND

Cervical collars are used in the treatment, stabilization, and therapyof cervical trauma. Some collars are intended to provide support forwhiplash and other such injuries where support for the head and neck isneeded. Other collars are intended for near complete immobilization ofthe head and neck, such as in an EMS pre-hospital setting.

There is often a rush to apply these collars onto the wearer due to theacute nature of cervical injuries. The collar must be selected toaccommodate the wearer's size in a quick manner for effectivestabilization and immobilization of the neck of the wearer.

Known cervical collars restrict spine flexion, extension and rotation topromote wearer recovery. Such known collars also include a tracheaopening allowing for healthcare clinicians the ability to perform quickcarotid pulse monitoring and emergency tracheotomies while providingcervical immobilization.

A drawback to known collars is that they are individually sized for avariety of standard wearer sizes. It follows that there is a need tostore many different sized collars in inventory which significantly addsto the cost for using such collars. In the event there is an emergency,and the proper sized collar is not available, the caregiver is givenlittle option other than to apply a poorly fitting collar on the wearersince many known collars provide minimal size adjustment.

Proper sizing is critical for wearer immobilization and comfort. Whilethere are a variety of different standard sizes, the wearer may havedimensions which fall outside of the standard sizes, and thus wear apoorly fitting collar that insufficiently immobilizes the wearer's neck.Such poor fitting may also cause significant discomfort to the wearer.

Over time, swelling of the wearer's neck may reduce which furthercomplicates the sizing of the collar. This may lead to the need fordisposing the initially selected collar and replacing it with a newcollar. This may lead to waste and an increase in cost.

When sizing a cervical collar, the first notable dimension concerns theheight. The height is measured by the vertical distance from the tip ofthe chin to the sternum; the other key dimension concerns thecircumference of the wearer's neck.

In addition to sizing, proper application of the collar is necessary forimmobilization and wearer comfort. A typical collar consists of frontand rear components which are packaged as a set according to the size ofthe wearer.

When applying a collar to the wearer, the rear component of the collaris applied to the back of the wearer's neck. Once the back wearer ispositioned appropriately, the front component of the collar ispositioned against the front or anterior portion of the neck so that achin support is placed against the chin. The front component is centeredto secure neutral alignment. The front component overlaps the rearcomponent to ensure effective immobilization and comfort. Straps arethen tightened to the collar with a bilateral adjustment which securesthe wearer's cervical region in neutral alignment.

SUMMARY

The present invention provides a cervical collar having height andcircumferential adjustment in order to accommodate a wide variety ofsizes of different wearers and to accommodate size changes caused byincreased or decreased swelling of the affected anatomical portions ofthe wearers.

According to an embodiment of the cervical collar, the cervical collarincludes a front component formed from a compressible foam material anddefines a recess forming a portion of a tracheal opening, and a heightadjustment mechanism secured to the front component and forming a rigidborder to the tracheal opening. The height adjustment mechanismselectively connects the front component to a sternum pad at apermanently locked position among a plurality of predefined distances.

In accordance with this disclosure, “permanently locked” is defined asonce the height adjustment mechanism is placed at a particular heightsetting among a plurality of predefined height settings, it can bepermanently locked at such height setting; no further adjustment of theheight of the collar is possible.

The cervical collar may include a rear component connecting to the frontcomponent, and have a plurality of lateral breakaway sections formed atside portions of the rear component. The breakaway sections are arrangedto be removed without the benefit of a tool such that removal of one ofthe breakaway sections reduces a circumference of the collar formed bythe combination of the front and rear components. The rear component maybe resiliently contoured in a generally arcuate shape such that thefront and rear components form from their arcuate shapes acircumferential configuration for securing about a wearer's neck.

The rear component may be formed from compressible foam, and include areinforcement support arranged to support a wearer's spine and anelongate strap arranged to secure to the front component. A rear gap maybe formed between a top portion of the reinforcement support and therear component. This gap may allow for expansion of the wearer's neckwithout reducing the circumference of the collar.

In an embodiment of the height adjustment mechanism, the heightadjustment mechanism includes an upper part secured to the frontcomponent, and a lower part secured to the sternum pad and bordering thelower portion of the tracheal opening. The lower part defines a firstarm bordering a side of the tracheal opening and the upper part definesa retainer through which the arm slides. The retainer is only located ata bottom portion of the upper part, such that when inserted through theretainer, the arm extends past the retainer and toward a top portion ofthe upper part. The location of the retainer permits the arms to besecurely connected to the upper part at the first point of engagement aswell as throughout the length of the height adjustment of the collar.

The first retainer may form a window and the arm may form a series oflocation identifiers representing a plurality of distance settings ofthe front component relative to the sternum pad. Preferably, anindividual one of the location identifiers may be arranged to be placedin register with the window when the arm is inserted into the retainer.A lip may be formed around each of the location identifiers, a lipcorresponding to the location identifier in the window engaging edges ofthe window. This window allows for the clinician to quickly compare theheight of the lower part relative to the upper part, assuring that bothsides are positioned at the same height.

According to a variation of the cervical collar, the upper part forms anelongate recess arranged to accommodate the arm. A variable gap isdefined between the uppermost section of the arm relative to the recessthereby permitting some adjustment of the uppermost section of the armrelative to the upper part.

In order to permanently lock the upper part relative to the lower partof the height adjustment mechanism, according to an embodiment of theheight adjustment mechanism, the lower part includes a pin fixedlysecurable to at least one of a series of locking elements formed alongthe upper part. The locking element into which the pin is securedcorresponds to the location identifier located in the window.

In a variation of the lower part, the lower part forms a central tabconnected to the sternum pad. The central tab has a living hinge adaptedto bias the tab and sternum pad to a remainder of the lower part. Also,the lower part may form a side tab corresponding to the arm, and theside tab may have a living hinge adapted to bias the side tab relativeto the sternum pad.

These and other features, aspects, and advantages of the presentinvention will become better understood with regard to the followingdescription, appended claims, and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front perspective view of an embodiment of the cervicalcollar.

FIG. 2 is a rear perspective view of the cervical collar of FIG. 1.

FIG. 3 is a side view of the cervical collar embodiment of FIG. 1showing a portion of the strap drawn back.

FIG. 4 is a front perspective view showing the cervical collar of FIG. 1placed on a wearer.

FIG. 5 is a side perspective view showing the cervical collar of FIG. 1placed on a wearer.

FIG. 6 is a front elevational view of a height adjustment mechanismembodiment.

FIG. 7 is a rear elevational view of the height adjustment mechanismembodiment of FIG. 6.

FIG. 8 is a side elevational view of the height adjustment mechanismembodiment of FIG. 6.

FIG. 9 is a perspective view showing another height adjustment mechanismembodiment.

FIG. 10 is a perspective view showing yet another height adjustmentmechanism embodiment.

FIG. 11 is a perspective view of another cervical collar embodiment.

FIG. 12 is a perspective of another rear component embodiment of thecervical collar.

FIG. 13 is a sectional view taken along line XIII-XIII in FIG. 12.

FIG. 14 is a perspective view of a front component embodiment of acervical collar.

FIG. 15 is a perspective view of a breakaway section from the frontcomponent embodiment of FIG. 14.

FIG. 16 is a perspective view exemplifying immobilization of a prior artcervical collar without height adjustment on a wearer.

FIG. 17 is a perspective view showing immobilization of the cervicalcollar according to FIG. 1 having height adjustment on a wearer.

It should be noted that the drawing figures are not necessarily drawn toscale, but instead are drawn to provide a better understanding of thecomponents thereof, and are not intended to be limiting in scope, butrather to provide exemplary illustrations. It should further be notedthat the figures illustrate exemplary configurations of a cervicalcollar having height and circumferential adjustment and the respectivecomponents thereof, and in no way limit the structures or configurationsof a cervical collar and components thereof according to the presentdisclosure.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS A. Environment and Context

Embodiments of an orthopedic device are provided for use in stabilizingand supporting anatomical portions of a wearer, for example, the neckand head of a wearer.

Although the embodiments of the disclosure are adapted for supportingand stabilizing anatomical portions of a large number of wearers havingvarious anatomical shapes and sizes, the embodiments of the disclosuremay also be dimensioned to accommodate different types, shapes and sizesof anatomical portions.

For ease of understanding the disclosed embodiments of an orthopedicdevice, the front or anterior, and rear or posterior portions of theorthopedic device are described independently. It will be recognizedthat the anterior and posterior portions of the orthopedic devicefunction together to form a supporting and stabilizing collar thatencompasses the anatomical portions of the wearer.

The term “posterior” also has its ordinary meaning and refers to alocation that is behind or to the rear of another location. Lastly, theterm “anterior” has its ordinary meaning and refers to a location thatis ahead of or to the front of another location.

The terms “rigid,” “semi-rigid,” “flexible,” and “compressible” may beused herein to distinguish characteristics of portions of certainfeatures of the orthopedic device. The term “rigid” is intended todenote that an element of the device is generally devoid of flexibility.Within the context of support members or shells that are “rigid,” it isintended to indicate that they do not lose their overall shape whenforce is applied, and in fact they may break if bent with sufficientforce. As for the term “semi-rigid,” this term is used to connoteproperties of support members or shells that provide support and arefree-standing; however such support members or shells may have somedegree of flexibility or resiliency.

On the other hand, the term “flexible” is intended to denote thatfeatures are capable of repeated bending such that the features may bebent into retained shapes or the features do not retain a general shape,but continuously deform when force is applied. The term “compressible”is used to qualify such structural features as being capable of beingreduced in size or volume due to the exertion of force applied to thestructural feature.

B. Various Embodiments of Cervical Collar

The cervical collar described herein includes front and rear componentsconstructed from flexible and compressible foam. Anterior and posteriorrigid plastic reinforcement supports are applied to the front and rearcomponents, respectively, to limit movement of the front and rearcomponents. Adjustable hook and loop fasteners couple the front and rearcomponents to one another, and secure to the anterior and posteriorreinforcement supports.

FIGS. 1 and 2 depict a first embodiment of a cervical collar 100 havinga front component 102, and a sternum pad 104 adjustably mounted to thefront component 102 by an anterior height adjustment mechanism 106. Theheight adjustment mechanism 106 has an upper part 108 fixably secured tothe front component 102, and a lower part 110 fixably secured to thesternum pad 104. A trachea opening 112 is formed between the upper andlower mechanism parts 108, 110 which are rigid or semi-rigid, therebyproviding a rigid or semi-rigid border to the trachea opening. This isparticularly advantageous should inspection or airway tubes be appliedat the trachea of the wearer.

The front component 102 is arranged to secure to a rear component 140 bya strap system 114 secured to strap loops 122 formed on the uppermechanism part 108, and strap slots 156 connected to the rear component140.

The front collar has a vein clearance configuration 143 as particularlydescribed in pending U.S. patent application Ser. No. 12/729,536, filedon Mar. 23, 2010, and incorporated herein by reference.

The sternum pad 104 is preferably constructed from a compressible andflexible foam or a similar material of any type described herein. Thelower mechanism part 110 defines a central tab 116 which may beconnected to the remainder of the lower mechanism part 110 via a centralliving hinge 118 so as to accommodate the movement and anatomy of awearer of the collar. Side tabs 130 straddle the central tab 116 and arespaced from the central tab 130 by a clearance 138. The side tabs 130may optionally include a living hinge 182 to likewise accommodatemovement and anatomy of a wearer. The sternum pad 104 may be secured tothe lower end of the lower mechanism part 110 via fasteners 120.

The adjustability of the height adjustment mechanism allows forselective positioning of the sternum pad 104 relative to the frontcomponent 102 so that the sternum pad 104 is spaced a height 170downwardly directed away from the front component 102, as shown in FIG.4. In order to know the settings of the location of the sternum pad 104relative to the front component 102, windows 128 are formed on opposedside of the upper mechanism part 108 which encircle or identify indicia126 indicating certain predetermined heights of the front component 102relative to the sternum pad 104. The upper mechanism part 108 definesgrooves 128 located at opposed sides of the trachea opening 112 and arearranged to accommodate the arms 124 of the lower mechanism part 110.

The rear component 140 has side end portions 142 that preferablyoutwardly overlap side end portions 141 of the front component 102 whichare located on the side portions 121, 123, respectively. While shown inthe preferred configuration, the cervical collar can be configured sothat the side end portions 141 of the front component outwardly overlapthe side end portions 142 of the rear component 140.

As shown in FIGS. 1-5, the front component 102 has a center portion 119whereupon the height adjustment mechanism 106 is secured and is locatedbetween boundaries 137, 139. The front component defines side portions121, 123 that extend beyond the center portion 119 along the anteriorside of the wearer's neck, and are without any reinforcement from theheight adjustment mechanism 106. The sternum pad 104 defines sideportions 131, 133 extending below and to the side of the heightadjustment mechanism 106, and also defines a lower portion 135 thatextends beyond and below the height adjustment mechanism 106 along awearer's sternum. The side portions 131, 133 and lower portion 135 arewithout any reinforcement from the height adjustment mechanism 106. Thefront component defines a chin portion 145 bulging outwardly relative tothe height adjustment mechanism 106, and only reinforced along itsunderside by the chin portion 164 of the height adjustment mechanism106.

A posterior reinforcement support 144 is secured along a midline 146 ofthe rear component 140. The reinforcement support 144 defines a middlesection 148, an uppermost section 150 and a lowermost section 152. Themiddle section 148 and the lowermost section 152 are preferably mountedflush to the rear component 140. The uppermost section 150 protrudesoutwardly from the rear component 140 so as to form a gap 158therebetween. The gap 158 allows for a slight expansion of the rearcomponent 140 relative to the reinforcement support 144 so as toaccommodate additional sizing of the wearer's neck. The middle andlowermost sections 150, 152 however are adapted to firmly restrain thewearer's spine regardless of any additional sizing of the wearer's neck,particularly since the fasteners are located along these sections of thereinforcement support.

The reinforcement support 144 is secured to the rear component 140 via aplurality of fasteners 154, and the strap system 114 secures to the rearcomponent 140 by slots 156 formed by the reinforcement support 144. Thereinforcement support is configured to have a cervical arch support soas to maintain neutral alignment of the cervical spine.

The rear component 140 has a pattern of openings 136 extending throughthe thickness of the rear component to provide for a circulation of airbetween the wearer and outside of the cervical collar, thereby reducingheat and moisture for the wearer due to wearing the collar. According tothis embodiment, the rear component includes a series of notches 132located at opposed end portions of upper and lower sections of the frontcomponent. At least one elongate opening 134 is defined between each setof upper and lower notches 132 to facilitate removing a section of thefront component in order to reduce the width of the collar. The opening134 may extend in part through the front component or extend through theentirety of the front component.

In reference to FIG. 3, the strap system 114 forms an adjustablebilateral hook and loop system to ensure proper fit. The strap systemincludes a strap 160 extending around the rear component 140 (throughthe slots 156 of the reinforcement support 144) and over the side endportions 141, and is securable to straps 162 mounted to the side endportions 142 of the front component 102. The strap 160 preferably has aloop material. The straps 162 preferably have a hook material engageablewith the loop material of the strap 160, and are mounted to the frontcomponent 102 via fasteners 190. The end portion of the strap 160includes a tab 166 which allows for the clinician to quickly mate thestraps 160, 162 so as to efficiently immobilize the neck of the wearer.

The upper part 108 of the height adjustment mechanism 110 defines a chinportion 164 generally protruding outwardly from the front component 102so as to form a gap 168. The gap 168 is variable in that the wearer canadjust the chin slightly while the neck is immobilized. There arepreferably no fasteners mounted near the uppermost portion of the upperpart, thereby allowing for some adjustability for the wearer of thecollar. It will be noted that the chin portion 164, as with theremainder of the height adjustment mechanism, is substantially rigid,therefore the variability of the gap is due at least in part to thecompressibility and flexibility of the front component relative to thechin portion.

As shown in FIGS. 4 and 5, the height adjustment mechanism 106 permitsheight adjustment 106 of the front component 102 relative to the sternumpad 104 over a range of heights 170 of the sternum pad 104 from thefront component 102 to thereby form a range of sizes to the tracheaopening. This height adjustment allows for the cervical collar to beprovided in a “one-size-fits-all” format, and permits the clinician toquickly immobilize the wearer's neck. The clinician can also reduceinventory cost without compromising the safety of cervicalimmobilization collar for the wearer. The height adjustment mechanismenables customization for individual requirements while not requiring anabundance of collars in stock.

FIGS. 6-8 illustrate a preferred embodiment of the height adjustmentmechanism 106, in greater scale than shown in FIG. 1. Particularly, thearms 124 of the upper part 108 each define indicia 126 along theirheight. A lip 180 is provided around each indicia 126, and the lip 180is configured in shape to be snugly received by the contours of thewindow 128 formed on the lower part 110. The lip thereby allows forserving as a guide prior to permanently locking the arms to the upperpart since they indicia corresponds to locking elements.

Each window is formed by a retainer 127 belonging to the upper part 108.The retainers 127 allow for the arms of the lower part to be insertedtherethrough such that the arms extend past the retainers 127 and intoan elongate and open recess 192 of the upper part. The recess 192 isarranged to receive a rear surface of the arm, whereas a front surfaceof the first arm is exposed above the first retainer. The retainer ispreferably located at a bottom portion of the upper part, such that whenthe arm is inserted through the retainer, the arm extends past theretainer and toward a top portion of the upper part.

The upper and lower parts 108, 110 form a border to the trachea opening112 of the cervical collar. Specifically, the upper part 108 defines theuppermost arch 176 and size portions 172, 174 of the trachea opening112, while an uppermost arch 177 of the lower part forms the lowermostarch of the trachea opening 112. The combination of these portions ofthe upper and lower parts allows for the trachea opening to bemaintained regardless of the height adjustment of the collar.

Each of the arms 124 defines a pin 184 that extends inwardly toward thefront component and is fixedly securable to at least one of a series oflocking elements 186 formed along the upper part. Each of the lockingelements 186 includes a plurality of fingers 188 which securely andlockingly engage the pin so that the pin 188 cannot be withdrawn fromthe locking element 186 once it is pressed thereinto.

As shown in FIG. 8, the arm 124 has a curvature that is not exactlyparallel to a curvature of the upper part 108. This lack of a parallelrelationship among the arm and the curvature, hence the recess 192 onthe upper part, results in a variable gap between portions of the armand the recess 192. By forming the arm 124 so that it is not exactlyparallel to the upper part 108, the height adjustment mechanism isstrengthened by minimizing the possibility of the height adjustmentmechanism at bending as well as forming a better fit when the pin islocked into the locking elements.

In accordance with the embodiments described herein, the front and rearcomponents, as well as the sternum pad are preferably constructed fromPLASTAZOTE or similar foam material. PLASTAZOTE itself is well known inthe art of cervical collars, and is distinguished as being compressibleand flexible. Specifically, PLASTAZOTE is a polyethylene foam and isconsidered as having excellent cushioning properties, thereby renderingthe front and rear components and the sternum pad as compressible andflexible. In accordance with the embodiments shown herein, the front andrear components conform to the shoulder, and the front component has amandible contour allowing for superior stability and comfort.

In the embodiments herein, the strap system is provided in combinationwith the compressible foam based front and rear components to providesufficient support to immobilize the neck of the wearer. Specifically,the arrangement of the front and rear components restricts cervicalspine flexion, extension and rotation to promote patient recovery.Moreover the use of PLASTAZOTE allows for the front and rear componentsto be latex-free, non-toxic and hypoallergenic.

The height adjustment mechanism and the reinforcement support aresubstantially rigid components, particularly provided to limit movementof the wearer's neck. The two piece design of the front and rearcomponents enhance patient comfort and compress and flex about thewearer's neck whereas the rigid height adjustment mechanism andreinforcement support remain rigid when worn by the wearer, and when thestrap system is tensioned about the neck of the wearer.

Of particular note, while the height adjustment mechanism allows for anadjustment in height of the collar, the height adjustment mechanismremains rigid so as to provide anterior support for the user. The heightadjustment mechanism borders the trachea opening thereby providing asubstantially rigid border about the trachea opening. This allows for alarge trachea opening, regardless of the height setting, and permits forquick access to the carotid pulse monitoring and emergencytracheotomies. It will also be noted that the variable gap between thegap between the chin portion of the height adjustment mechanism and thefront component makes the cervical collar maneuverable for assisting inairway management of the cervical collar for the wearer.

According to this embodiment, the locking of the height adjustmentmechanism is arranged to be permanently locked at one of thepredetermined heights defined by the indicia so that the wearer cannotchange the height setting once it has been locked. The benefit of thisembodiment is that the height adjustment mechanism is more secure, withless risk of accidentally unlocking it. There is also a reduction in therisk that of the patient changing the setting. However, the embodimentsherein are not to be limited to permanent locking elements, and it iswithin the scope of the invention to make the locking elementsadjustable and not permanent.

FIG. 9 depicts another embodiment of a height adjustment mechanism 200.In this embodiment, the adjustment mechanism 200 has top and bottomparts 202, 204, wherein a rod 206 extends from the top part 202 into areceptacle 208 having a fitting contour 212 located on the bottom part204. The rod 206 defines a plurality of breaks 214 having indicia 216which correspond to different height sizes.

In operation, the rod 206 is provided in the largest configuration, asexemplified by “XL.” Should the wearer have a shorter height, the breakaccording to the wearer's size is snapped so that the rod 206 is reducedin height and inserted into the receptacle 208. The fitting contour 212is configured in a manner such that there is a frictional fit with thelowermost end of the rod 206 when inserted therein.

FIG. 10 exemplifies yet another adjustment mechanism 220 having top andbottom parts 222, 224, wherein an end portion 226 extends over thebottom part 224. The end portion 226 defines an elongate slot 228 and aplurality of locking recesses 230 generally arranged along the slot 228.The slot 228 may be provided with detents which correspond to thelocking recesses.

The bottom part 224 includes a slider 232 which extends through andengages the slot 228, and an arm 94 laterally extending from a side ofthe bottom part 224 and generally in alignment with the slider 232. Thearm 234 carries a head 236 having a fastening element 238, such as arivet or a locking pin, which is adapted to engage one of the lockingrecesses 230. The locking recesses 230 are arranged in a pattern whichcorresponds to different height settings of the collar.

In operation, the caregiver moves the slider in the slot so that it isaligned with one of the locking recesses. Once aligned at the propersetting, the arm is turned over the edge of the top and bottom parts.The fastening element is then pressed into the locking recesses whereatit engages and effectively maintains the desired collar height.

The fastening element may be arranged to permanently lock into one ofthe locking recesses. By permanently locking, the collar cannot betampered with by the wearer, the tampering of which can result inimproper alignment and lack of immobilization for the wearer.

Of course, a variety of other adjustment mechanisms are available, andthe adjustment mechanism can be modified in a manner to accommodate suchother adjustment mechanisms.

FIG. 11 depicts another embodiment of the cervical collar includingtightening bands 260 used to stabilize the arms 124 against the upperpart 108 by connecting between the lower part 110 on the sternum pad 104and the side end portions 141 of the front component 102. The tighteningbands 260 secure at a first end 270 to the front component side endportions 141, either behind the side portions 142 of the rear component140, or forward the side end portions 142. The tightening bands 260secure at a second end 264 to the fasteners 120. The tightening bands260 are preferably removable at both the first and second ends.

The tightening bands stabilize the height adjustment mechanism such thatwhen the collar is set in the lowest setting, the tightening bands areloose. When the height adjustment mechanism is in its tallest setting,the tightening bands are fully stretched and maintain the sternum pad inplace against the wearer by urging forces 268 against the wearer.

FIG. 12 illustrates another embodiment of the rear component 280 of thecervical collar. According to this embodiment, the rear component 280includes a base rear portion 282 having side portions 284 extendingtherefrom. A reinforcement support 296 is provided on the rear surfaceof the rear component 280, and may be arranged similarly as depicted inFIG. 2.

Each of the side portions 284 has breakaway sections 286 correspondingto different lengths of the side portions 284. Removal of the breakawaysections 286 allow for the clinician to easily reduce the circumferenceof the rear component and hence the cervical collar. The breakawaysections 286 are delimited by areas of reduced thickness 290 at whichlocations the breakaway sections 286 are configured to be torn away fromthe base rear portion 282 according to a certain circumferential size ofthe wearer.

As an alternative to the areas of reduced thickness, the breakawaysections may be delimited by a line of perforations such that theseperforations comprises a plurality of thin holes that permit easytearing of the breakaway sections from the base rear portion.

The rear component 280 includes a plurality of openings 288 to provideventilation to the wearer. Of particular note, certain of the openings288 outside of the rear portion 282 may be confined within the breakawaysections 286 themselves so as to avoid uneven edges of the rearcomponent 100.

FIG. 13 exemplifies a configuration of how the breakaway sections 286are constructed. In this example, the areas of reduced thickness 290include notches 302, 304 extending along the entire height of the innerand outer sides of the rear component 280. While the notches 302, 304result in reducing the thickness of the side portions 284, they providea thickness that allows for tearing away from the rear portion 282, butstill enable functionality of the side portions when the correspondingbreakaway sections 300, 306 (and so forth) are not removed from the rearportion.

Other configurations are available for constructing the breakawaysections which would be understood by the skilled person. It will benoted that the notched sections can have a thickness which withstandtearing, and instead, they merely serve as areas which facilitate thecutting of the side portions to accommodate a specific wearer's size.

Aside from the breakaway sections which are depicted as being adapted toadjust the circumference of the collar, other breakaway sections may beprovided to modify the collar for different medical indications. Forexample, it has been found that the rear of the collar does notnecessarily require adjustment in height. However, for patients thatonly require support for flexion, lowering the support in the back wouldincrease breathability and comfort to the wearer.

In addition to the breakaway sections, the collar can be provided with aplurality of inserts for each of the openings. These inserts arearranged, including the configuration of reduced thickness, perforationsor other means known to the skilled person, for easy detachment from thecollar. Prior to adjustment, the collar has these openings filled withthe inserts and the caregiver can adapt the collar by removing theseinserts so that certain area have greater ventilation than other areasaccording to the demands of the wearer.

Turning to the embodiment 320 of FIG. 14, the front component 322 canhave width adjustment by the use of removable segments 326, 328 onopposed end portions of the front component. The removable segments 326,328 are secured to the front component by an interlocking profile 324formed along at least one of the vertical peripheries of the removablesegments. Opposed vertical peripheries of either the front componentitself 322 or the removable segments 326, 328 are precut with theinterlocking profile 324 so that the opposed vertical peripheriesinterlock.

Because the interlocking removable segments are precut, they are readilyseparable from the front component and will include generally cleanlines demarcating a portion of the periphery of the front component. Theinterlocking profile is preferably of a low profile allowing forinterlocking of the parts, while minimizing contours of the interlockingprofile so as to avoid a substantially jagged profile.

If it is desired to reduce the width of the collar, then one may pullapart the desired removable segment to form the new width of the frontcomponent. If in the event it is desired to add width to the collar, onemay place the removed segment to the front component, or in thealternative, an extension segment 338 having an interlocking profile340, as shown in FIG. 15, may be added to the front component. Theextension segment 338 has a greater width than the removable segments326, 328 and may be placed together with the removable segments or aloneon the front component.

The sternum pad 330 may include removable segments 334, 336 havinginterlocking profiles 332 which are adapted to be added to or removedfrom the sternum pad. The embodiment in FIG. 14 shows by way of examplehow any of the foam components of the collar, whether the frontcomponent or the rear component, and the sternum pad may be arranged tohave width and height adjustment from interlocking, removable segments.The front and rear components and the sternum pad may have either thewidth or height adjustment with interlocking removable segments, or mayinclude both width and height adjustment with interlocking removablesegments.

FIGS. 16 and 17 depict the motion restriction obtained by known cervicalcollars in comparison to the adjustable cervical collar of theinvention. In the example depicted in FIG. 16, a well known collar namedthe Philadelphia Tracheotomy Collar and sold by Ossur hf is shown tohave motion restriction of the nodding motions of the neck whereas forflexion F (bending the neck toward the chest) the distance is about 27mm, and for extension E (bending the neck back) the distance is about 20mm from a neutral position N.

By properly sizing the cervical collar using the height adjustmentmechanism and sternum pad described herein, FIG. 17 shows the cervicalcollar of the invention as having a motion restriction of about 20 mmfor flexion F, and about 20 mm for extension E from a neutral positionN. The height adjustment mechanism of the cervical collar in FIG. 17thereby allows the clinician to assure that the collar tightlyimmobilizes the wearer's neck, and particularly allows for superiorimmobilization for extension.

It is particularly advantageous for a cervical collar to have excellentmotion restriction so as to limit or prevent cervical pain, protectspinal instability, and protect the cervical spine in emergencysituations. Cervical collars have also been found to provide benefits ofproprioception and decreased loading to injured muscles or ligaments byincreased support to the region. Moreover, it is likely that thosecervical collars have the benefit of increasing local temperature of thesoft tissue surrounding the cervical region by reducing heat loss andproviding a placebo effect.

By having the ability to tailor the size of the collar bothcircumferentially and by height, and further including means forventilating the collar and reducing foam size (such as by only includinga sternum pad), the cervical collar of the invention allows for improvedpain relief, immobilization, restraint against extreme neck motions, andrest of soft tissue surrounding the neck.

While the foregoing embodiments have been described and shown, it isunderstood that alternatives and modifications of these embodiments,such as those suggested by others, may be made to fall within the scopeof the invention. Moreover, any of the principles described herein maybe extended to any other orthopedic devices.

The invention claimed is:
 1. A cervical collar having an adjustableheight, comprising: a front component constructed from a compressiblefoam material, the front component defining a portion of a trachealopening located within a center portion of the front component and sideportions extending from opposed sides of the center portion; a heightadjustment mechanism directly secured to the front component at only thecenter portion of the front component, the height adjustment mechanismforms a substantially rigid border about an entirety of a periphery ofthe tracheal opening, the center portion defined to include the trachealopening and areas of the cervical collar proximate the tracheal opening;and a sternum pad formed from a compressible foam material, the heightadjustment mechanism selectively connecting the front component to thesternum pad at a permanently locked position among a plurality ofpredefined distances defined along an adjustable length located betweenthe front component and the sternum pad and forming part of the heightof the cervical collar; wherein the height adjustment mechanism includesan upper part secured to the front component and bordering an upperportion of the tracheal opening, the upper part defines a chin portionprotruding outwardly from the front component so as to form a gapvariable in that the wearer can adjust the chin slightly while the neckis immobilized; wherein the sternum pad borders a lower portion of thetracheal opening, a lower part of the height adjustment mechanismdefining a central tab having a living hinge, and side tabs, the sidetabs straddling the central tab and the side tabs are spaced apart fromthe central tab by a clearance, the sternum pad is secured to the lowerpart of the height adjustment mechanism by fasteners at the side tabs.2. The cervical collar according to claim 1, wherein the lower part ofthe height adjustment mechanism defines a first arm bordering a side oftracheal opening, the upper part defining a first retainer through whichthe first arm slides, the upper part further defining a first recessformed as being elongate and open above the first retainer which islocated at a bottom portion of the upper part and is arranged tosurround the first arm, the first recess is arranged to receive a rearsurface of the first arm, whereas a front surface of the first arm isexposed above the first retainer.
 3. The cervical collar according toclaim 2, wherein the first retainer forms a window, the first arm formsa series of location identifiers representing a plurality of distancesettings of the front component relative to the sternum pad, anindividual one of the location identifiers arranged to be placed inregister with the window when the first arm is inserted into the firstretainer.
 4. The cervical collar according to claim 2, wherein the firstretainer is only located at a bottom portion of the upper part, suchthat when inserted through the first retainer, the first arm extendspast the first retainer and toward a top portion of the upper part. 5.The cervical collar according to claim 2, wherein a top portion of thefirst arm forms a pin, the upper part forming a plurality of lockingelements above the retainer into which the pin is arranged to bepressed, wherein each locking element includes a plurality of fingersarranged to securely and lockingly engage the pin such that the pincannot be withdrawn from the locking element once pressed thereinto soas to be permanently locked.
 6. The cervical collar according to claim1, wherein the lower part of the height adjustment mechanism includes apin fixedly securable to at least one of a series of locking elementsformed along the upper part.
 7. The cervical collar according to claim6, wherein the lower part of the height adjustment mechanism defines afirst arm bordering a side of tracheal opening, the upper part defininga first retainer bottom portion of the upper part through which thefirst arm slides into a first recess formed as being elongate and openabove the first retainer; wherein the first retainer forms a window, thefirst arm forms a series of location identifiers representing aplurality of distance settings of the front component relative to thesternum pad, an individual one of the location identifiers arranged tobe placed in register with the window when the first arm is insertedinto the first retainer; wherein the lower part includes a pin fixedlysecurable to at least one of a series of locking elements formed alongthe upper part, the locking element into which the pin is securedcorresponds to the location identifier located in the window.
 8. Thecervical collar according to claim 7, wherein a lip is formed aroundeach of the location identifiers, the lip corresponding to the locationidentifiers in the window engaging edges of the window.
 9. The cervicalcollar according to claim 1, wherein the upper part forms a first recesswhich is elongate and open, and arranged to accommodate a rear surfaceof the first arm and a front surface of the first arm extends outsidethe recess.
 10. The cervical collar according to claim 9, wherein avariable gap is defined between the rear surface of an uppermost sectionof the first arm relative to the first elongate recess.
 11. The cervicalcollar according to claim 1, wherein there are no fasteners mounted nearthe uppermost portion of the upper part, thereby allowing for someadjustability for the wearer of the collar, the chin portion issubstantially rigid and variability of the gap is due at least in partto the compressibility and flexibility of the front component relativeto the chin portion.
 12. The cervical collar according to claim 1,wherein the lower part of the height adjustment mechanism defines afirst arm bordering a side of tracheal opening, the upper part defininga first retainer through which the first arm slides, the upper parthaving a curvature and the first arm having a curvature different fromthe upper part curvature wherein the curvature of the first arm is notparallel to the curvature of the upper part such that the heightadjustment mechanism is strengthened by minimizing bending of the heightadjustment mechanism.
 13. The cervical collar according to claim 1,further comprising a rear component connecting to the front component,the rear component having a plurality of breakaway sections arranged tobe removed without the benefit of a tool, whereby removal of one of thebreakaway sections reduces a circumference of the cervical collar formedby the combination of the front and rear components.
 14. The cervicalcollar according to claim 1, further comprising a rear component formedfrom a compressible foam and connecting to the front component, the rearcomponent including a reinforcement support arranged to support awearer's spine and an elongate strap arranged to secure to the frontcomponent.
 15. The cervical collar according to claim 1, wherein thesternum pad has side portions extending below and to the side of theheight adjustment mechanism, and also defines a lower portion that isadapted to extend beyond and below the height adjustment mechanism, theside portions and the lower portion of the sternum pad are locatedoutside of the height adjustment mechanism.
 16. The cervical collaraccording to claim 1, wherein the sternum pad has a width that isnarrower in size than the width of the front component.
 17. The cervicalcollar according to claim 1, wherein the height adjustment mechanismdefines a pair of strap loops extending from opposed sides of the heightadjustment mechanism, the cervical collar further comprising a pair ofstraps extending from the strap loops and along side portions of thefront component beyond the center portion of the front component outsidethe height adjustment mechanism.
 18. The cervical collar according toclaim 1, wherein the upper and lower parts define uppermost andlowermost arches forming part of the trachea opening.
 19. A cervicalcollar having an adjustable height, comprising: a front componentconsisting of a compressible and flexible foam material, the frontcomponent defining opposed front and rear surfaces; a substantiallyrigid height adjustment mechanism secured at a center portion of thefront surface of the front component, the height adjustment mechanismhaving a lower part defining a central tab connected to a remainder ofthe lower part via a living hinge, and side tabs, the side tabsstraddling the central tab and the side tabs are spaced apart from thecentral tab by a clearance; and a sternum pad formed from a compressiblefoam material, the height adjustment mechanism selectively connectingthe front component to the sternum pad at a permanently locked positionamong a plurality of predefined distances defined along an adjustablelength located between the front component and the sternum pad, whereinthe sternum pad is directly secured only to the lower part of the heightadjustment mechanism by fasteners at the side tabs and arranged to bespaced a height downwardly directed away from the front component, thecentral tab adapted to bias the sternum pad relative to the remainder ofthe lower part; wherein the front component defines side portionsextending beyond the center portion and located outside the heightadjustment mechanism.
 20. The cervical collar according to claim 19,wherein the height adjustment mechanism defines a pair of strap loopsextending from opposed sides of the height adjustment mechanism, thecervical collar further comprising a pair of straps extending from thestrap loops and along the side portions of the front component extendingbeyond a center portion of the front component outside the heightadjustment mechanism.
 21. The cervical collar according to claim 19,wherein the central tab has a width less than a width defined byuppermost and lowermost arches of the height adjustment mechanism.